基于体质量指数分层的加压给氧在肥胖患者腹腔镜胆囊切除术后肩部疼痛中的差异化疗效分析

摘要/Abstract

摘要：

目的探讨基于体质量指数（body mass index，BMI）分层的加压给氧对肥胖患者腹腔镜胆囊切除术后肩部疼痛的差异化疗效。方法纳入 2021 年 1 月至 2023 年 12 月河池市人民医院收治的 80 例腹腔镜胆囊切除术后肩部疼痛患者，按随机数字表法分为对照组与试验组，每组各 40 例。对照组实施常规吸氧与疼痛管理，试验组采用 BMI 分层加压给氧（BMI 30 ～＜ 35kg/m2：5cmH2O；BMI ≥ 35kg/m²：7cmH₂O）联合腹式呼吸训练。比较两组加压给氧前后血气分析、术后疼痛及并发症发生情况。结果干预后，两组患者动脉血二氧化碳分压（arterial blood carbon dioxide partial pressure，PaCO2）较干预前均显著下降，试验组 PaCO2 降低幅度显著高于对照组，差异具有显著性（P ＜ 0.05）；两组动脉血氧分压（arterial partial pressure of oxygen，PaO2）的提升幅度无显著差异（P ＞ 0.05）。试验组术后 48h、72h 数字分级评分法评分显著低于对照组，且疼痛缓解有效率（87.50%）显著高于对照组（65.00%），差异均有显著性（P ＜ 0.05）。试验组（12.50%）与对照组（17.50%）并发症总发生率无显著差异（P=0.531），干预后，试验组总体舒适度评分为（2.16±0.63）分，低于对照组 [（3.85±0.72）分 ]，差异有显著性（t=11.171，P ＜ 0.001）。结论基于 BMI 分层的加压给氧可有效改善肥胖患者术后通气功能、加速疼痛缓解，安全性良好。

关键词: 体质量指数, 加压给氧, 腹腔镜, 术后, 肩部疼痛, 肥胖

Abstract:

Objective To investigate the differential efficacy of pressurized oxygen administration based on body mass index(BMI) stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy. Method 80 patients with shoulder pain after laparoscopic cholecystectomy in Hechi people's Hospital from January 2021 to December 2023 were selected and randomly divided into control group and experimental group, 40 cases in each group. The control group received conventional oxygen inhalation and pain management, and the experimental group received stratified hyperbaric oxygen (BMI 30 ～＜ 35kg/m²: 5cmH2O;

BMI ≥ 35kg/m²: 7cmH2O) combined with abdominal breathing training. Blood gas analysis, postoperative pain and complications were compared between the two groups before and after pressurized oxygen therapy. Result After the intervention, the arterial blood carbon dioxide partial pressure (PaCO2) of the two groups decreased significantly compared with that before the intervention, and the reduction of PaCO2 in the experimental group was significantly higher than that in the control group (P ＜ 0.05); There was no significant difference in the increase of arterial partial pressure of oxygen (PaO2) between the two groups (P ＞ 0.05). The digital grading score at 48 hours and 72 hours after operation in the experimental group was significantly lower than that in the control group, and the effective rate of pain relief (87.50%) was significantly higher than that in the control group (65.00%), with significant differences (P ＜ 0.05). There was no significant difference in the total incidence of complications between the experimental group (12.50%) and the control group (17.50%) (P=0.531). After the intervention, the overall comfort score of the experimental group was (2.16±0.63), which was lower than that of the control group (3.85±0.72), and the difference was significant (t=11.171, P ＜ 0.001). Conclusion Hyperbaric oxygenation based on BMI stratification can effectively improve postoperative ventilation function and accelerate pain relief in obese patients, with good safety.

Key words: Body mass index, Pressurized oxygen supply, Laparoscopic, Postoperative, Shoulder pain, Obesity

施彩金, 覃利逢, 黄兰鲜, 黄宝票, 蓝禾. 基于体质量指数分层的加压给氧在肥胖患者腹腔镜胆囊切除术后肩部疼痛中的差异化疗效分析 [J]. 临床普外科电子杂志, 2025, 13(4): 29-.

Shi Caijin, Qin Lifeng, Huang Lanxian, Huang Baopiao, Lan He. Differential efficacy of pressurized oxygen administration based on body mass index stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy [J]. Journal of General Surgery for Clinicians, 2025, 13(4): 29-.

[1]	李文兵, 蔡一亭. 单切口加 1 孔腹腔镜手术在结直肠癌根治术中的可行性和临床应用价值 [J]. 临床普外科电子杂志, 2025, 13(4): 2-.
[2]	宁海兵, 何海清. 腹腔镜下钬激光碎石术治疗胆管结石的临床效果及对创伤应激指标的影响 [J]. 临床普外科电子杂志, 2025, 13(4): 34-.
[3]	李文迪, 梁婕, 史光军, 刘彩云. 加速康复外科模式下微创胆总管切开取石术的临床体会 [J]. 临床普外科电子杂志, 2025, 13(4): 38-.
[4]	濮忠军. 内镜逆行胰胆管造影联合腹腔镜胆囊切除术处理胆囊结石合并胆总管结石的策略优化 [J]. 临床普外科电子杂志, 2025, 13(4): 47-.
[5]	郑飞, 尤理想, 董栋栋, 陈玲. 腹腔镜阑尾切除术联合四磨汤治疗急性阑尾炎的疗效分析 [J]. 临床普外科电子杂志, 2025, 13(4): 62-.
[6]	王新立 , 李晓泉 . 超声引导下区域阻滞结合全身麻醉对接受腹腔镜结肠癌根治术患者应激与疼痛水平的影响 [J]. 临床普外科电子杂志, 2025, 13(4): 66-.
[7]	李雪, 吴胜文. 基于信息 - 干预 - 反馈 - 评估 - 响应模式的心理护理干预对腹腔镜胃肠道手术患者疼痛程度及睡眠质量的影响 [J]. 临床普外科电子杂志, 2025, 13(4): 101-.
[8]	粟艳林. 比较腹腔镜中间入路、尾内侧入路单向环路式手术在右半结肠癌患者中的效果及安全性 [J]. 临床普外科电子杂志, 2025, 13(3): 41-.
[9]	蔡得生 , 鲍传庆 , 吴吉 . 单切口腹腔镜结肠癌根治术对老年结直肠癌患者术后免疫能力和应激反应的影响 [J]. 临床普外科电子杂志, 2025, 13(3): 46-.
[10]	朱佳妮, 李松, 陈国梁, 夏阿东, 汤杰 . 腹腔镜胃癌 D2 根治术对老年局部进展期胃癌患者的影响 [J]. 临床普外科电子杂志, 2025, 13(2): 28-.
[11]	王佐, 马瑞斌, 郭志豪, 于晓萍, 焦辉. 腹腔镜胆囊切除术手术经验总结与探讨 [J]. 临床普外科电子杂志, 2025, 13(2): 32-.
[12]	陈勇彪. 探究腹腔镜胆囊切除术治疗胆囊结石并慢性胆囊炎中的疗效及安全性 [J]. 临床普外科电子杂志, 2025, 13(2): 41-.
[13]	梁小雷. 腹腔镜联合胆管镜治疗胆囊结石合并胆总管结石的临床应用研究 [J]. 临床普外科电子杂志, 2025, 13(2): 45-.
[14]	于洋, 王洪华, 杨国保, 朱军君, 陈胜男. 腹腔镜胆总管切开取石一期缝合术与 T 形管引流术在胆总管结石患者中的疗效对比 [J]. 临床普外科电子杂志, 2025, 13(2): 54-.
[15]	王茂强, 黄涛, 赵建波, 孙海峰, 陈正修, 何灵生, 王建宇, 梁锋, 廖剑明, 黄焕基. 腹腔镜联合硬质胆道镜弹道碎石取石术治疗肝胆管结石患者的临床分析 [J]. 临床普外科电子杂志, 2025, 13(2): 60-.

基于体质量指数分层的加压给氧在肥胖患者腹腔镜胆囊切除术后肩部疼痛中的差异化疗效分析

Differential efficacy of pressurized oxygen administration based on body mass index stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价